SHM Converge Scientific Abstract ePoster Gallery-Impact of Direct Provider Feedback and Peer Comparison on Reducing Routine Daily Laboratory Testing

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This study examined whether direct provider feedback and peer comparison could reduce routine daily laboratory testing, specifically CBC and BMP orders, for hospitalized patients. Excessive daily labs are known to increase costs, trigger unnecessary downstream testing and procedures, and contribute to iatrogenic anemia, while previous efforts to reduce testing have not worsened patient outcomes.<br /><br />The intervention included 106 providers who received individualized feedback every three months from August 2023 to October 2024, following an educational grand rounds session. Feedback reported each provider’s total lab orders and the percentage ordered as “in AM daily,” and included peer comparison. CBC and BMP orders were collected from direct hospitalist care floors between July 2023 and August 2024.<br /><br />Results showed meaningful reductions in daily ordering behavior. “In-AM daily” rates decreased from 62% to 57% for CBC orders and from 62% to 55% for BMP orders, both statistically significant. BMP orders per patient encounter day also declined from 56% to 53%, while CBC rates remained unchanged at 72%. About 67% of orders were placed by providers who received feedback.<br /><br />Overall, the study found that direct provider feedback and peer comparison reduced routine daily lab ordering and encouraged more thoughtful use of laboratory tests. Importantly, this was achieved without mandatory electronic medical record restrictions, suggesting that feedback alone can influence provider behavior and lower unnecessary BMP utilization even when not all providers are included in the feedback pool.

Asset Subtitle

Alex Lane

Meta Tag

Author List Alex Lane, Han Li, Vahid Azimi

Category Research

Concept Blood Count

Concept Basic Metabolic Panel

Concept Iatrogenic Anemia

Concept Provider Feedback

Concept Individualized Feedback

Distinguished Non-Finalist

Presenter Organization Washington University in St. Louis

Presenting Author Alex Lane

Track Quality Improvement

Keywords

daily laboratory testing

CBC orders

BMP orders

provider feedback

peer comparison

hospitalized patients

lab utilization

routine daily labs

order reduction

iatrogenic anemia

Blood Count

Basic Metabolic Panel

Iatrogenic Anemia

Provider Feedback

Individualized Feedback